TBA Religious School Registration Non-member

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Email address

Student's English Name

Student's Hebrew Name

Please include the child’s Hebrew name. If you do not know it or if the child does not have one, please contact Deb Schutzman at 978-927-3211, ext.4, or deb.schutzman@tbabeverly.org

Date of Birth

Grade as of September 2021

Is this your child's first year at TBA Religious School?

YesNo

Parent's English Name & Surname

Parent's Hebrew Name

Parent's English Name & Surname

Parent's Hebrew Name

Address

May we add your child’s name & family’s contact information to the school directory?

YesNo

May we use your child’s photograph for promotional purposes (brochures, web, etc)?

YesNo

Home Phone

Cell Phone

If parents are divorced or separated, please complete the following:

Custodial Parent's Name

Do you wish all mailings regarding the child go to both parties?

YesNo

Sat, April 20 2024 12 Nisan 5784